Editor’s Note: The 2023 Chinese Congress of Holistic Integrative Oncology (2023 CCHIO) will be held in Tianjin from November 16th to 19th, 2023 Mr.Balázs Rozványi. Mr. Rozványi, who is the President of the Hungarian League Against Cancer (HLAC), will deliver a speech entitled ‘The role of the Hungarian League Against Cancer as a civil organization in cancer control’ at 2023 CCHIO. Oncology Frontier interviewed Mr.Rozványi to share the cancer epidemic characteristics in Hungary and the experience of the HLAC in cancer control.
Oncology Frontier: Could you please introduce the epidemic characteristics and diagnosis and treatment status of cancer in Hungary?
Mr. Rozványi: I prepared some statistical data of Hungary and how it is compared to Europe. There was a publication about Hungary (EU Country Cancer Profiles 2023) and it was published in this year. So the up-to-date data is reachable. It was prepared by the European Commission and the Organization for Economic Co-operation and Development (OECD). According to this the incidence in Hungary in 2020 was about 10% higher than the average Europe incidence, so we are in not a good position about these statistical numbers. In Hungary, the incidence was 628 per 100,000 population. It’s an average age standardised rate. The mortality was 328 (per 100,000 population), which is 33% higher than the average Europe data. So, we are in a bad position.
The most common cancers are in Hungary between men is the prostate cancer, it’s about 20%, lung cancer is 18% and colorectal cancer is 17%. In Europe the situation is almost the same. The first three most common cancers are in women, the breast cancer with 24%, second is lung cancer with 14% and the third one is colorectal cancer with 14%. In Europe a little bit differs because the second is the colorectal (12%) and the third one is the lung cancer (9%). About the death rates, lung, colorectal, breast and pancreatic cancers are the leading causes of death. Lung is 84 per 100,000 population and colorectal is 51 per 100,000 population.
We also have some good news, because there is a reduction in cancer mortality in the last decade between 2011 and 2019. In Hungary, the reduction is 11% for men in Hungary and 10% for men in Europe. In women it’s 6% in Hungary and 5%. in Europe. So in this field we are a little better than the average European countries but there is a big difference between the countries.
We have some public health screenings in Hungary, following the common practice in the Western countries, including breast cancer, cervical cancer and colorectal cancer screening. Specifically, breast cancer screenings are recommended for women aged 45 to 65, while cervical cancer screenings are advised for women between the ages of 25 and 65. For colorectal cancer, screening is recommended for individuals of both genders who fall within the age range of 50 to 70 years. In terms of the participation rates, for breast cancer screening, approximately less than 40% of the invited women attend mammography screenings. The participation rate for cervical cancer screening is below 10%, which is quite low. But is has to be emphasized that more women have this screening, but not in the public health screening program. As for colorectal cancer screening, it falls somewhere between 30% and 40%.
We started HPV vaccination between young people about 12 or 13 years old. We started with girls in 2014 and with boys in 2021. And nowadays both girls and boys can get this HPV vaccination, and the vaccination rate is 80% between girls and 70% between boys. I think it’s not bad at all.
Oncology Frontier: What role has the Hungarian League Against Cancer (HLAC) played in cancer prevention and treatment? Please share your experience.
Mr. Rozványi: This organisation was established in 1990. That means it’s 33 years old and we have members all over the country. And I can say that this is the far biggest cancer patient organisation in Hungary. We have 3,000 members, but we are a small country. It means if I multiply with your numbers, it would mean about 400,000-450,000 members all over China.
We are members of a lot of international organisations, as the UICC, the ECL, the European Cancer League, the ECPC, the European Cancer Patient Coalition, Europa Uomo, this is specialised for prostate cancer patients, and the Lymphoma Coalition. And I can say that the Hungarian League Against Cancer is a member of the international professional organisations, and we play a main role in international information and disseminating educational materials. One of these is the European Code Against Cancer.
This is a recommendation of the IARC, the International Agency for Research on Cancer, an institution of the WHO. The first edition of the European Code Against Cancer was launched in 1987. Nowadays, we are at the fourth edition, and these are recommendations for the healthy lifestyle in the field of cancer. These are about prevention and lifestyle, don’t smoke, keep your home and workplace smoke-free, or about physical activity, or diet, or helping vaccinations, and so on. We are on this topic the partner of the IARC, the International Agency for Research on Cancer. We made the Hungarian implementation of the ECAC promote and disseminate it. There are e-learning modules of ECAC at the IARC website, and we translated it to Hungarian to be reachable for the Hungarian people. And now a mobile phone application is under construction on the topics of ECAC. We are a member of the international consortium led by ECL that is managing the development.
Our vision is that we work for a future in which healthy people preserve their health, and cancer patients are treated with the highest professional standards, and they live a good quality of life in dignity. We have a lot of awareness programs all over the year. It begins in January with the World Cancer Walk. It’s an international event at the very beginning of January. The European Cervical Cancer Prevention Week is in the third week of January. We celebrate the World Cancer Day on the 4th of February and the Hungarian National Cancer Day on the 10th of April. The European Week Against Cancer is in the last week of May. Men’s Health Week, is in the second week of June. World Lymphoma Awareness Day is on the 15th of September. On this day, we usually organize a bicycle tour in Budapest. The color of the lymphoma is green, that is why we wear green T-shirts and ride green bicycles across the city from one hospital to another. These are the most important hematological centers in the country. It’s not a long ride, about 8 kilometers, but it’s a very good event to communicate about lymphoma, why is it important. In October, we organize a lot of breast cancer awareness events all over the country. It begins with a motorbike ride from many cities and towns. A lot of motorbikers come to Budapest, and they have a parade across the city in pink T-shirts written ‘Against breast cancer by motorbike’. It’s on the last Saturday of September, and after it, in October, we have the breast cancer awareness events all over the country, as I mentioned. We have a patient academy, and we also celebrate the Movember movement about prostate cancer in November.
We have a lot of programs and sessions for patients and volunteers. We train our volunteers and educate them. We have a 10,000-step program with physiotherapy for prostate cancer patients. Our Keep Moving program is about physical activity with collecting kilometers by the participants for a healthy lifestyle. Usually, we have a cycle tour across the country to promote this Keep Moving program. We have about 80 clubs for patients and for their families (if we multiply with your numbers, it would mean about 12.000 clubs all over in China). There are clubs for patient groups with Meet-the-Doctor Sessions about the topics of the patients, mental health clubs, art therapy and creative clubs, exercise clubs as yoga, hiking, cycling, walking, Nordic walking, folk dance, rehabilitation dance club, meridian exercises, and about diet, called ‘Wooden spoon’, because you cook with wooden spoon.
We run the nationwide helpline and information service. We have school programs and kindergarten programs for the very young, where we teach the healthy lifestyle, the self-examination for the teenagers. We print leaflets and information booklets. We organize screenings. That means practically the simplest screenings as a melanoma screening or a PSA test. We have organized a lot of fundraising programs. We have bought many medical instruments such as six mammography machines and different instruments for the cancer patients.
Oncology Frontier: Hungary has deeply participated in ‘the Belt and Road’. What are your expectations for the cooperation between CACA and HLAC?
Mr. Rozványi: There are many differences between our countries and the cancer organizations. But I think we can learn from each other a lot. We can change experiences and find useful similarities and differences for both partners. As I know well, in your country, in China, smoking is a big problem. In Hungary it was also a big problem. Every fourth adult person was a smoker, a daily smoker. And in five years, it could reduce to every fifth person. We have anti-smoking legislation. That means that smoking is forbidden practically in all public places as in workplaces, restaurants, pubs, movies, theaters, bus, train and train stops. You can smoke only on the street if you are not very close to an entry of a building, or there is no school, no bus stop, no train stop, and so on. Smoking causes most of the cancers: 82% of lung cancers are caused by smoking; and at laryngeal cancers, it’s over 80% also. I don’t know that in China is there a population-based or a healthcare-organized screening about these cancer types, or other cancer types, but maybe it would be useful. And the sharing of good practices can also be part of this cooperation.
